Senior Analyst, Audit and Compliance Analytics (Hybrid NY)

HealthFirst•New York, NY

1d•$83,100 - $120,360•Hybrid

About The Position

The Senior Analyst, Audit and Compliance Analytics leverages healthcare data, analytical tools, and business knowledge to support Internal Audit, Compliance Analytics, and Claims Configuration Audit initiatives. This role partners with cross-functional teams to identify risks, evaluate controls, analyze claims and configuration data, and develop reporting that supports operational excellence, compliance, and payment accuracy. The individual will work on strategic initiatives with visibility across the organization and contribute to data-driven decision making.

Requirements

Bachelor’s degree from an accredited institution or equivalent work experience
3+ years of equivalent experience
Proficiency in scripting and programming skills
Experience using MS Office suite, including Microsoft Access, Excel, and Word
Expertise in utilizing data analysis and query tools such as SQL
Experience with Alteryx, Tableau, Amazon Redshift, or other similar tools/platforms
Experience with applied statistics skills, such as distributions, statistical testing, regression, etc.
Ability to successfully run queries from a data warehouse
Expertise innovating and implementing audit techniques
Excellent communication skills
Excellent time management and the ability to prioritize work and complete assignments within their allotted deadline
Experience working with and communicating technical information to multiple levels of technical and non-technical staff in written and verbal form
Experience prioritizing a heavy workload in a fast-paced environment

Nice To Haves

Master’s degree from an accredited institution
Degree in Mathematics, Computer Science, Data Sciences, Engineering, Business Analytics, Informatics, or similar concentration
Experience with analytical programming techniques such as Python and R
Experience with AWS and analytical solutions available on the platform (Redshift, Glue, Sage Maker, etc.)
Familiarity with programming in JavaScript, D3.js
Familiarity with big data technologies, such as Hadoop, MapReduce, and AWS Kinesis
Demonstrated ability to develop innovative solutions to complex problems, leveraging advanced problem-solving skills and sound judgment to make critical, independent decisions within area of responsibility
Knowledge of modern machine learning algorithms (clustering, classification and regression), statistical methods and optimization
Knowledge of health care industry, systems, business strategies and products

Responsibilities

Analyze complex healthcare datasets to identify trends, anomalies, control gaps, and potential compliance or operational risks.
Support Internal Audit, Compliance, and Claims Configuration Audit activities through data analysis, audit testing, monitoring, and reporting.
Develop advanced SQL, SAS, or other analytical queries to extract, validate, and analyze data from multiple sources.
Evaluate data quality and standardize data structures to support consistent reporting and analysis.
Create and maintain dashboards, scorecards, reports, and monitoring tools that provide actionable insights to leadership and business stakeholders.
Summarize findings, methodologies, and recommendations for technical and non-technical audiences.
Assist in the validation of claims configuration changes, business rules, and operational controls.
Document analytical processes, data issues, methodologies, and business requirements.
Collaborate with Internal Audit, Compliance, Claims Operations, Configuration, IT, and other business partners.
Demonstrate intellectual curiosity and identify opportunities for process, control, and reporting improvements.
Additional duties as assigned.